Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2024.12.003
K. Goudsmit , A. Tran , A. Tauziède-Espariat , M. Veyrat
Introduction
Progressive anosmia, unlike sudden-onset viral or traumatic anosmia, requires endoscopic screening for nasal polyps. In the absence of polyposis, radiological work-up should diagnose and treat any curable pathology. Here, we report the case of a patient treated for olfactory cleft actinomycosis.
Results
A 72 year-old man, without relevant medical history, was referred for progressive hyposmia and unilateral greenish rhinorrhea resistant to well-conducted medical treatment. Nasal endoscopy and imaging suggested a fungus ball in the left olfactory cleft. Endoscopic surgery fully restored olfaction, with histologic confirmation of actinomycetes.
Discussion
The present case highlights the importance of prompt diagnosis in progressive anosmia, and demonstrates the efficacy of exclusively surgical management.
{"title":"Progressive anosmia revealing olfactory cleft actinomycosis: A CARE case report","authors":"K. Goudsmit , A. Tran , A. Tauziède-Espariat , M. Veyrat","doi":"10.1016/j.anorl.2024.12.003","DOIUrl":"10.1016/j.anorl.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Progressive anosmia<span>, unlike sudden-onset viral or traumatic anosmia, requires endoscopic screening for </span></span>nasal polyps. In the </span>absence<span> of polyposis<span>, radiological work-up should diagnose and treat any curable pathology. Here, we report the case of a patient treated for olfactory cleft actinomycosis.</span></span></div></div><div><h3>Results</h3><div><span>A 72 year-old man, without relevant medical history<span>, was referred for progressive hyposmia and unilateral greenish </span></span>rhinorrhea<span><span> resistant to well-conducted medical treatment. Nasal endoscopy and imaging suggested a </span>fungus ball<span> in the left olfactory cleft. Endoscopic surgery<span><span> fully restored olfaction, with histologic confirmation of </span>actinomycetes.</span></span></span></div></div><div><h3>Discussion</h3><div>The present case highlights the importance of prompt diagnosis in progressive anosmia, and demonstrates the efficacy of exclusively surgical management.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Pages 247-250"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2024.11.012
S. Wu , F. Jian
Nasal septal perforations (SP) are common yet challenging conditions encountered in otorhinolaryngology. Endoscopic repair of nasal septal perforations using nasal pedicle mucosal flaps has become an important treatment method. However, there are no established guidelines for selecting the appropriate mucosal flaps for repair, and the choice largely depends on the surgeon's experience. This study outlines the procedure and benefits of utilizing a unilateral inverted mucosal flap from the nasal septum, along with criteria for selecting suitable cases for this surgical approach. The technique is best suited for moderate-sized perforations located in the anterior nasal septum, with a diameter of less than 2cm. The mucosa around the perforation is thicker. It is essential that the nasal mucosa is healthy and that the perforation edges have sufficient bony and cartilaginous support to prevent mucosal adhesion on both sides of the septum, which could hinder the complete separation of the inverted mucosal flap. Our findings suggest that, with careful case selection, the repair technique involving a unilateral inverted mucosal flap combined with stitching methods is a feasible option. This approach not only simplifies the surgical procedure but also significantly reduces its complexity, making it more accessible to those new to the field.
{"title":"Modified ‘cross-stealing’ repair of nasal septal perforation using unilateral inverted mucosal flap","authors":"S. Wu , F. Jian","doi":"10.1016/j.anorl.2024.11.012","DOIUrl":"10.1016/j.anorl.2024.11.012","url":null,"abstract":"<div><div><span>Nasal septal perforations<span><span> (SP) are common yet challenging conditions encountered in otorhinolaryngology. Endoscopic repair of nasal septal perforations using nasal </span>pedicle<span> mucosal flaps has become an important treatment method. However, there are no established guidelines for selecting the appropriate mucosal flaps for repair, and the choice largely depends on the surgeon's experience. This study outlines the procedure and benefits of utilizing a unilateral inverted mucosal flap from the nasal septum, along with criteria for selecting suitable cases for this surgical approach. The technique is best suited for moderate-sized perforations located in the anterior nasal septum, with a diameter of less than 2</span></span></span> <span>cm. The mucosa<span> around the perforation is thicker. It is essential that the nasal mucosa is healthy and that the perforation edges have sufficient bony and cartilaginous support to prevent mucosal adhesion on both sides of the septum, which could hinder the complete separation of the inverted mucosal flap. Our findings suggest that, with careful case selection, the repair technique involving a unilateral inverted mucosal flap combined with stitching methods is a feasible option. This approach not only simplifies the surgical procedure but also significantly reduces its complexity, making it more accessible to those new to the field.</span></span></div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Pages 255-259"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2025.08.001
C.-A. Righini , C. Fabre
{"title":"The most commonly used free flap for reconstruction in ENT oncology","authors":"C.-A. Righini , C. Fabre","doi":"10.1016/j.anorl.2025.08.001","DOIUrl":"10.1016/j.anorl.2025.08.001","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Pages 224-225"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2025.02.005
F. Micaletti , M. Marx , L. Pelle-Boudeau , N. Alfaqan , J.J. Galvin 3rd , D. Bakhos
Objective
To assess audiological outcome in adult (> 18 years) cochlear implant (CI) users with a straight (SA) or perimodiolar electrode array (PMA).
Material and methods
Between 2017 and 2021, medical records of patients in 2 French centers who received a Cochlear™ SA (CI522/CI622) or PMA (CI532/CI632) CI were retrospectively analyzed according to the STROBE guidelines. Air-conduction pure-tone audiometry and disyllabic speech audiometry were recorded over a minimum 3-year follow-up. Only patients with thresholds above 90 dB at low frequencies (500 Hz) before surgery were considered to have residual hearing (RH). Surgery-related complications (e.g., vertigo, peripheral facial palsy, meningitis) were assessed. The significance threshold was set at P < 0.005.
Results
We included 185 adult patients: 94 SA and 91 PMA. Median age at CI was 64.5 ± 11.5 years for SA and 60.9 ± 12.2 years for PMA. Preoperative unaided pure-tone averages (PTA) were comparable between SA and PMA (100 and 102 dB, respectively; P = 0.32), as were postoperative aided free-field air-conduction PTAs at 3 months (30.9 ± 6.0 and 31.3 ± 8.8 dB, respectively; P = 0.68). Percentage correct dissyllabic word responses at 60 dB HL did not significantly differ between SA and PMA before CI (P = 0.483), or 1 year (P = 0.775), 2 years (P = 0.441) or 3 years (P = 0.785) post-CI, although there was a significant difference at 3 months post-CI (P = 0.001) in favor of PMA. Fifty-one patients (21 SA, 30 PMA) had RH prior to surgery; after 12 months’ CI experience, 14.2% of these had RH in the SA group and 13.3% in the PMA group. One peripheral facial palsy occurred in the SA group but resolved completely (P > 0.99). Twenty patients experienced transient postoperative vertigo (10 SA [10.6%], 10 PMA [10.9%]; P = 0.93). No meningitis was noted.
Conclusion
CI with straight or perimodiolar electrodes provided similar improvement in audiological performance.
{"title":"Audiometry results in adult cochlear implant patients according to the electrode array","authors":"F. Micaletti , M. Marx , L. Pelle-Boudeau , N. Alfaqan , J.J. Galvin 3rd , D. Bakhos","doi":"10.1016/j.anorl.2025.02.005","DOIUrl":"10.1016/j.anorl.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>To assess audiological outcome in adult (><!--> <!-->18<!--> <!-->years) cochlear implant (CI) users with a straight (SA) or perimodiolar electrode array (PMA).</div></div><div><h3>Material and methods</h3><div>Between 2017 and 2021, medical records of patients in 2 French centers who received a Cochlear™ SA (CI522/CI622) or PMA (CI532/CI632) CI were retrospectively analyzed according to the STROBE guidelines. Air-conduction pure-tone audiometry and disyllabic speech audiometry were recorded over a minimum 3-year follow-up. Only patients with thresholds above 90<!--> <!-->dB at low frequencies (500<!--> <!-->Hz) before surgery were considered to have residual hearing (RH). Surgery-related complications (e.g., vertigo, peripheral facial palsy, meningitis) were assessed. The significance threshold was set at <em>P</em> <!--><<!--> <!-->0.005.</div></div><div><h3>Results</h3><div>We included 185 adult patients: 94 SA and 91 PMA. Median age at CI was 64.5<!--> <!-->±<!--> <!-->11.5<!--> <!-->years for SA and 60.9<!--> <!-->±<!--> <!-->12.2<!--> <!-->years for PMA. Preoperative unaided pure-tone averages (PTA) were comparable between SA and PMA (100 and 102<!--> <!-->dB, respectively; <em>P</em> <!-->=<!--> <!-->0.32), as were postoperative aided free-field air-conduction PTAs at 3<!--> <!-->months (30.9<!--> <!-->±<!--> <!-->6.0 and 31.3<!--> <!-->±<!--> <!-->8.8<!--> <!-->dB, respectively; <em>P</em> <!-->=<!--> <!-->0.68). Percentage correct dissyllabic word responses at 60<!--> <!-->dB HL did not significantly differ between SA and PMA before CI (<em>P</em> <!-->=<!--> <!-->0.483), or 1<!--> <!-->year (<em>P</em> <!-->=<!--> <!-->0.775), 2<!--> <!-->years (<em>P</em> <!-->=<!--> <!-->0.441) or 3<!--> <!-->years (<em>P</em> <!-->=<!--> <!-->0.785) post-CI, although there was a significant difference at 3<!--> <!-->months post-CI (<em>P</em> <!-->=<!--> <!-->0.001) in favor of PMA. Fifty-one patients (21 SA, 30 PMA) had RH prior to surgery; after 12<!--> <!-->months’ CI experience, 14.2% of these had RH in the SA group and 13.3% in the PMA group. One peripheral facial palsy occurred in the SA group but resolved completely (<em>P</em> <!-->><!--> <!-->0.99). Twenty patients experienced transient postoperative vertigo (10 SA [10.6%], 10 PMA [10.9%]; <em>P</em> <!-->=<!--> <!-->0.93). No meningitis was noted.</div></div><div><h3>Conclusion</h3><div>CI with straight or perimodiolar electrodes provided similar improvement in audiological performance.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Pages 226-232"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2025.04.008
F. Boubaker , U. Puel , S. Imbs , A. Blum , C. Parietti-Winkler , R. Gillet
Aim
To determine which anatomical parameters of the round window (RW) influence the surgical approach for cochlear implantation and in which plane they should be measured.
Material and methods
Sixty-six patients (40 females and 26 males; mean age: 60.4 ± 17.7 [26–84] years) who underwent preoperative ultra-high resolution CT underwent cochlear implantation between February 2020 and March 2024. Two radiologists reviewed the anatomical parameters of the RW niche (type, minimal width), membrane (size, inclination) and bony overhang (size, inclination) in the axial, parasagittal and Stenvers planes.
Results
The RW membrane size in the Stenvers plane was the most reproducible and the only difference between patients requiring a promontory cochleostomy approach and those with an easy RW approach, with an optimal cut-off value of 1.55 mm for the need for a cochleostomy. The RW membrane size in the parasagittal and Stenvers planes were highly correlated. The minimum width and type of the RW niche and the size and inclination of the RW bony overhang did not influence the surgical approach and had variable interobserver agreement.
Conclusion
The size of the RW membrane should be measured in the Stenvers plane. Other anatomical parameters of the RW do not influence the surgical approach.
{"title":"Round window measurements for cochlear implantation with UHR-CT: Importance of the Stenvers plane and membrane size","authors":"F. Boubaker , U. Puel , S. Imbs , A. Blum , C. Parietti-Winkler , R. Gillet","doi":"10.1016/j.anorl.2025.04.008","DOIUrl":"10.1016/j.anorl.2025.04.008","url":null,"abstract":"<div><h3>Aim</h3><div>To determine which anatomical parameters of the round window (RW) influence the surgical approach for cochlear implantation and in which plane they should be measured.</div></div><div><h3>Material and methods</h3><div>Sixty-six patients (40 females and 26 males; mean age: 60.4<!--> <!-->±<!--> <!-->17.7 [26–84] years) who underwent preoperative ultra-high resolution CT underwent cochlear implantation between February 2020 and March 2024. Two radiologists reviewed the anatomical parameters of the RW niche (type, minimal width), membrane (size, inclination) and bony overhang (size, inclination) in the axial, parasagittal and Stenvers planes.</div></div><div><h3>Results</h3><div>The RW membrane size in the Stenvers plane was the most reproducible and the only difference between patients requiring a promontory cochleostomy approach and those with an easy RW approach, with an optimal cut-off value of 1.55<!--> <!-->mm for the need for a cochleostomy. The RW membrane size in the parasagittal and Stenvers planes were highly correlated. The minimum width and type of the RW niche and the size and inclination of the RW bony overhang did not influence the surgical approach and had variable interobserver agreement.</div></div><div><h3>Conclusion</h3><div>The size of the RW membrane should be measured in the Stenvers plane. Other anatomical parameters of the RW do not influence the surgical approach.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Pages 238-243"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2024.11.010
C. Thibault , M. Mailly , C. Debry , P. Schultz , L. Fath
Retrograde cricopharyngeal dysfunction (RCPD) syndrome renders patients unable to belch, causing disabling symptoms that impact quality of life. Injection of botulinum toxin into the cricopharyngeal muscle has been reported as a trial treatment for both therapeutic and diagnostic purposes. We describe the injection technique, under general anesthesia using endoscopy or by transcutaneous injection with electromyographic control.
{"title":"Botulinum toxin injection for retrograde cricopharyngeal muscle dysfunction syndrome","authors":"C. Thibault , M. Mailly , C. Debry , P. Schultz , L. Fath","doi":"10.1016/j.anorl.2024.11.010","DOIUrl":"10.1016/j.anorl.2024.11.010","url":null,"abstract":"<div><div>Retrograde cricopharyngeal dysfunction (RCPD) syndrome renders patients unable to belch, causing disabling symptoms that impact quality of life<span><span>. Injection of botulinum toxin<span> into the cricopharyngeal muscle has been reported as a trial treatment for both therapeutic and diagnostic purposes. We describe the injection technique, under general anesthesia using </span></span>endoscopy or by transcutaneous injection with electromyographic control.</span></div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Pages 251-254"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.anorl.2024.10.001
F. Rubin
{"title":"The heart of the citation black-market","authors":"F. Rubin","doi":"10.1016/j.anorl.2024.10.001","DOIUrl":"10.1016/j.anorl.2024.10.001","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 5","pages":"Page 223"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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